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    OpenPayerBilling CodesPreventive Behavior Intensive Program for Prevention Of DiabetesCPT cpt-0488t-group-diabetes-prevention-remote-intensive-education
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    CPT 0488T: Intensive Group Diabetes Prevention Education, Online

    CPT code 0488T describes a provider-delivered, intensive group curriculum of behavioral modification and lifestyle change education for diabetes prevention delivered online or via electronic technology at 30-day intervals; service type: group diabetes prevention education (intensive behavioral/lifestyle intervention); typical site of service: virtual/telehealth group setting.

    For related coverage guidance, see recent payer policy updates: Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation, Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation, Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult at high risk for type 2 diabetes identified during a primary care visit based on prediabetes laboratory results (elevated fasting glucose or A1c), obesity, metabolic syndrome, or strong family history. The patient is enrolled in an intensive, standardized diabetes prevention curriculum delivered online or via electronic technology with group education sessions scheduled at 30‑day intervals. The clinical workflow begins with referral by the primary care provider or endocrinologist, baseline assessment (weight, BMI, fasting glucose or A1c, blood pressure), consent for participation in the virtual program, and setup of the telehealth platform. A certified diabetes educator, registered dietitian, or trained lifestyle coach leads the monthly group sessions, provides structured behavior modification lessons (nutrition, physical activity, goal setting, self-monitoring), documents attendance and progress, and communicates outcomes to the referring clinician. Administrative tasks include scheduling, billing using 0488T, applying appropriate modifiers for special circumstances, and recording outcome measures (weight loss, activity logs, follow-up laboratory testing) in the electronic health record.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99401Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual; approximately 15 minutesIndividual brief preventive counseling that may precede enrollment in the group prevention program or be used for follow-up between group sessions.
    99406Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutesUsed when focused brief counseling for tobacco cessation is delivered as part of lifestyle modification components in the program.
    G0447Face-to-face behavioral counseling for obesity, 15 minutesIndividual or group obesity counseling that complements weight‑loss components of the diabetes prevention curriculum.
    99409Preventive medicine counseling and/or risk factor reduction intervention(s); 30 minutesLonger individual counseling sessions that align with the intensity of behavior modification provided in the program.
    99078Physician or other qualified health care professional service(s) in a group setting, patient education; nonphysician provider, per sessionAlternative group education billing sometimes used for nonphysician-led sessions or supplementary group classes associated with the program.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Q00000X
    163W00000X
    251B00000X
    364SE1400X
    163WR0400X
    208600000X
    364SC0200X
    1223P0221X

    Related Payer Policy Updates

    Specialty: Cardiology1 / 4

    10 rows

    PolicyPayerEffective Date
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2027-02-05
    Percutaneous Left Atrial Appendage Closure - Medical PolicyHealth-New-England2027-02-01
    Transcatheter Mitral Valve Repair Medical PolicyHealth-New-England2027-02-01
    Cardiac Electrophysiological (EP) Studies and Cardiac Ablation of Abnormal Electrical RhythmsCigna2027-01-15
    Biomarkers for Myocardial Infarction and Chronic Heart Failure Reimbursement PolicyHealthfirst2026-11-01
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2026-11-01
    Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillationpremerabluecrossofwashington2026-11-01
    Cardiology - TryvioCigna2026-11-01

    Related Codes

    CPT-0403T-GROUP-DIABETES-PREVENTION-INTENSIVE-CURRICULUM

    CPT 0403T: Intensive Group Diabetes Prevention Education

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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